Systemic immune‐inflammation index to predict placenta accreta spectrum and its histological subtypes

Abstract

Aim: In this study, we aimed to investigate the role of systemic immune-inflammation index (SII) and other inflammatory parameters in the diagnosis of placenta accreta spectrum (PAS) and its histological subtypes. Methods: This retrospective case-control study included patients who underwent surgery for placenta previa (PP). Case group (patients with PAS) included pregnant women diagnosed with histologically confirmed PAS, whereas control group (patients with PP) included pregnant women who underwent cesarean section with a PP diagnosis, required no additional intervention during the operation. Both groups were compared with respect to their demographic data, clinical characteristics, SII, and other laboratory parameters. Cut-off values that can predict PAS were calculated. The PAS group was separated into subgroups based on histology findings, and inflammatory parameters were compared between subgroups. Results: In this study, data of 273 patients were analyzed. Of these, 68 (24.9%) were included in the PAS group and 205 (75.1%) patients were included in the PP group. Significant differences were observed in SII, platelet distribution width, mean platelet volume, neutrophil-to-lymphocyte ratio, and platelet-tolymphocyte ratio (p = 0.000, p = 0.006, p = 0.002, p = 0.000, and p = 0.000, respectively). The best SII cut-off value was 985.02109/L (57.4% sensitivity and 72.2% specificity). There was no significant association between the histologic subtypes of PAS and inflammatory parameters. Conclusion: SII can be used to predict PAS in pregnant women with PP. The relationship between the histologic subtypes of PAS and inflammatory parameters should be investigated in more comprehensive studies.

Histopathologic Changes in the Placenta of Pregnant Women with Preeclampsia

“…Oxidative stress, hypoxia, ischemia, and tissue necrosis of the placenta are associated with endothelial cell activation and maternal inflammatory responses. Various innate and adaptive immune cells and mediators play a role in this process 12,13 . Regulatory T cells, macrophages, natural killer cells and neutrophils are known to contribute to preeclampsia, but other immune cells such as B cells, inflammatory cytokines and autoantibodies directed against the angiotensin II type 1 receptor have also been recently discovered 13 .…”

“…In addition to activating the immunological cascade that leads to the development of pre-eclampsia, the immunological balance plays a key role in the remodeling of the spiral artery. Studies have shown that disruption of the low flow resistance of the spiral artery affects the histologic structure of the placenta to some extent 11,12 .…”

The Importance of Evaluating Hematologic Parameters in the Diagnosis of Acute Appendicitis Among Pregnant Patients

“…[26] It was used in the evaluation of pathologies such as placental anomalies, hyperemesis gravidarum, and peripartum cardiomyopathy during pregnancy and it was found to be significantly higher. [27][28][29] There is no study in the literature examining the relationship between SII and AA. In their study, Telaferli and colleagues found that the increase in SII level was more pronounced in patients with complicated AA than in patients with uncomplicated AA who were not pregnant.…”

Can systemic immune inflammation index measured in the first trimester predict later occurring isolated oligohydramnios?

“…Both NLR and PLR have been shown to be correlated with cancer and several inflammatory diseases, and have begun being regarded as likely inflammatory markers [6][7]. The system immune-inflammation index (SII), used as a novel inflammatory biomarker in recent years, has been shown to be associated with adverse obstetric outcomes such as placental pathologies [8][9]. To the best of our knowledge, there have been no reports to date of the importance of the SII in women with IO in the first trimester.…”